Money, Politics and the Decline of American Health
13 Sep, 2012
Money in politics is making our nation sicker, threatening our national security, and ultimately destroying the very economic prosperity the “money in politics” seeks to achieve. It is undermining our capacity to care for our citizens and threatening our global economic competitiveness in invisible, insidious ways. The links, connections and patterns that promote obesity and chronic disease are clear, though. The economic and social impacts are evident. As health care consumes an increasingly large percentage of our federal budget, the negative impacts of money in politics have become too alarming too ignore, and never more obvious than in this election cycle of 2012.
It may seem odd to suggest that lobbying, and in particular Citizens United, the Supreme Court decision that personifies corporations and allows unlimited corporate campaign contributions through political action committees, threatens our nation’s health. But it does.
If money rules politics, then our nation is not protected from disease-causing Frankenfoods including soda and processed foods, or from unrestricted marketing of the lowest-quality, sugar-laden foods to our children. When money rules politics, our agricultural lands, soils and aquifers are depleted through oil-dependent industrial farming supported by billions in federal subsidies.
Depleting Nature’s and Human Capital
We are depleting nature’s capital—capital that once destroyed, cannot be reclaimed. One acre of arable land is lost to development every minute of every day. One pound of meat requires 2,000 gallons of water and produces 58 times more greenhouse gases than 1 pound of potatoes. It takes 7,000 pounds of grain to produce 1,000 pounds of meat. Irrigation is depleting our Ogallala Aquifer on the Great Plains 1.3 trillion gallons faster than it can be replenished by rainfall. Three-quarters of our fresh water (only 5 percent of all the earth’s water) is used for agriculture, mostly to grow meat for human consumption.
If we all switched out one meat meal for a vegetarian meal each week, it would be the equivalent of taking half a million cars off the road. Driving a Hummer and being a vegetarian produces less greenhouse gases than driving a Prius and eating factory farmed meat. Yet when the USDA (United States Department of Agriculture) encouraged us to participate in “Meatless Mondays,” the National Cattleman’s Beef Association lobbied the government to retract their recommendation. And they did. Money in politics.
During health reform, I mentioned to Senator Harkin that all we wanted was for science to become policy. With a wry and somewhat sad smile he said, “That would be nice.”
Our energy policies support Orwellian “clean coal” that still discharges mercury, lead and particulate matter into our air, promoting heart disease, cancer and more, and our politically handicapped Environmental Protection Agency allows environmental policies that permit untested chemicals and toxins to permeate our lives. Should we worry when the average newborn has 287 known toxins in his or her umbilical cord blood that have been linked to neurodevelopment disorders such as attention deficit disorder and autism that now affects 1 in 6 of our nation’s children? What are the social and economic costs of that?
The reason we have these policies is not that they were encouraged and supported by citizens through a democratic process or grassroots movement. The policies are there for one reason—they were encouraged, shaped, lobbied for and even often ghostwritten by industries whose sole focus is profit, not public welfare.
Money in Health Care: Perverse Incentives
If money rules politics, then the most profitable medical therapies, not the best treatments, are researched and implemented. If hospitals and doctors are paid for volume and piecework, they produce more visits and procedures, but not better health. If hospitals suddenly cut cardiac bypasses and angioplasties in half by implementing proven intensive lifestyle therapies, they would go bankrupt. If Medicare refused to reimburse for cardiac bypasses or angioplasties proven to work in less than 5 percent of patients that receive them, and instead reimbursed for intensive lifestyle treatment programs for those with heart disease and diabetes, health care costs, as estimated by the Cleveland Clinic, would be reduced by almost one trillion dollars over the next 10 years. But since lifestyle treatment is not reimbursed it is not profitable, so it is not done.
At a recent medical innovation conference, I met with the head of Walgreen’s new Take Care Clinic and was impressed with their focus on education and service. But when I asked if he would implement a program that could be delivered through their clinics that could reduce prescription medication use by half, he was not interested. They want to appear to do the right thing, but not do it.
The head of health information technology from Partner’s Health Care, the Harvard group of hospitals, shared at a medical administrators meeting that the head of the Harvard health system rejected a proposal to connect two hospitals by a data line that would save 15 percent in labs costs by reducing redundant lab tests. They couldn’t afford a 15 percent reduction in lab billing.
Perverse economic incentives drive policy and medical decisions, not the best interests of the patients, and certainly not better health outcomes. Violation of public trust, the sacred covenant between our elected leaders and our people, results from money in politics. What ever happened to government by the people, for the people and of the people? My friend, lawyer and environmental advocate Robert F. Kennedy, Jr., calls our political system a “corporate kleptocracy.” Communism, he says, is when the government runs business; and fascism is when business runs government.
Our nation’s health and economy are close to entering an irrevocable downward spiral. It is difficult for most of us to grasp the immensity of the politically sanctioned economic forces at work that threaten our health. This quiet, dangerous set of forces in play in American society fuel the explosive and uncontrolled growth of disease in America.
Accounting for Sustainability: The True Cost of Money in Politics
The basic fact is that one-third of our economy profits from making people sick and fat. The food industry sells products scientifically proven to kill more people than cigarettes, while our health care industry profits from providing more volume of care focused on medication and procedures, not better health.
Certain facts are clear. Lifestyle-induced chronic disease is on the rise, and accounts for nearly 80 percent of our health care costs. Nearly 70 percent of our population is overweight or obese. Almost 1 in 4 teenagers have pre-diabetes or Type 2 diabetes, up from only 9 percent in 2000 and almost zero in 1960. Most chronic disease is best prevented and even treated with lifestyle medicine and a systems approach to disease. By 2042, 100 percent of our federal budget will be needed to pay for Medicare and Medicaid. Today, 1 in 3 Medicare dollars is spent on Type 2 diabetes. This is unsustainable.
The true cost of our food and agriculture, energy, education, environmental policies on our health are not even measured in the equation. Our government subsidizes the production of low-cost high-fructose corn syrup and trans fats from soybeans (used to make soda and French fries), but we don’t do an accurate cost accounting of the health, environmental and energy impact of producing those crops in the way we do, or the health impact on the children and adults who consume those products.
Prince Charles gave a speech at the Future of Food conference at Georgetown University in 2011. He describes a new kind of cost accounting, “accounting for sustainability” that expands our accounting processes to include the interconnected impact of financial, health, environmental and social impact on long-term “profits.”